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Emotional vulnerability and cognitive control in patients with bipolar disorder and their healthy siblings: a pilot study

Published online by Cambridge University Press:  24 June 2014

Kathrin Houshmand ,
Peter Bräunig ,
Siegfried Gauggel ,
Katrin Kliesow ,
Rahul Sarkar  and
Stephanie Krüger
Kathrin Houshmand
Affiliation:
Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
Peter Bräunig
Affiliation:
Department of Psychiatry, Humboldt Klinikum Vivantes, 13437 Berlin, Germany
Siegfried Gauggel
Affiliation:
Department of Medical Psychology and Medical Sociology, University Hospital Aachen, 52074 Aachen, Germany
Katrin Kliesow
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technical University, 01307 Dresden, Germany
Rahul Sarkar
Affiliation:
Department of Psychiatry, Humboldt Klinikum Vivantes, 13437 Berlin, Germany
Stephanie Krüger*
Affiliation:
Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
*
Dr Stephanie Krüger, Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany. Tel: +49 30 450517215; Fax: +49 30 450517944; E-mail: [email protected]
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Abstract

Scheuch K, Bräunig P, Gauggel S, Kliesow K, Sarkar R, Krüger S. Emotional vulnerability and cognitive control in patients with bipolar disorder and their healthy siblings: a pilot study.

Objective:

There is evidence that, even in remission, patients with bipolar disorder (BD) have deficits in cognitive function and emotional regulation. Siblings of patients with BD are also reported to exhibit minor dysfunction in neuropsychological domains. In this study, we examined the interference of acute mood state with reaction time (RT) and response inhibition in euthymic patients with BD, in their healthy siblings and in healthy controls.

Methods:

A total of 34 patients with bipolar I disorder, 22 healthy siblings and 33 healthy controls performed a stop-signal paradigm after induction of a transient intense sadness and a relaxed mood state. The differences in RT and the response inhibition were compared between the groups.

Results:

Euthymic patients with BD displayed a higher emotional reactivity compared with their siblings and with controls. Compared with controls, patients with BD showed longer RTs in a relaxed mood state and a delay in response inhibition during emotional activation.

Conclusions:

The present study provides evidence for the clinical observation that patients with BD have shorter RTs when in a state of emotional arousal rather than in a relaxed state. Inhibitory deficits in these patients may be because of a too strong emotional arousal. The results show that in patients with BD, relaxation and emotional arousal are inversely associated with performance in a neuropsychological task. This is in contrast to findings in healthy individuals suggesting a dysbalance in emotional regulation in these patients.

Keywords

Bipolar Depression Rating Scalebipolar disordercluster analysisinternational studiesreliabilityscale validation
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 22 , Issue 2 , April 2010 , pp. 54 - 62
Copyright
Copyright © 2010 John Wiley & Sons A/S

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References

Balanzá-Martínez, V, Tabarés-Seisdedos, R, Selva-Vera, Get al. Persistent cognitive dysfunctions in bipolar I disorder and schizophrenic patients: a 3-year follow-up study. Psychother Psychosom 2005;74:113–119. CrossRefGoogle ScholarPubMed
Martínez-Arán, A, Vieta, E, Colom, Fet al. Cognitive impairment in euthymic bipolar patients: implications for clinical and functional outcome. Bipolar Disord 2004;6:224–232. CrossRefGoogle ScholarPubMed
Martínez-Arán, A, Vieta, E, Reinares, Met al. Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. Am J Psychiatry 2004;161:262–270. CrossRefGoogle ScholarPubMed
Ferrier, IN, Stanton, BR, Kelly, TP, Scott, J.Neuropsychological function in euthymic patients with bipolar disorder. Br J Psychiatry 1999;175:246–251. CrossRefGoogle ScholarPubMed
Clark, L, Iversen, SD, Goodwin, GM.Sustained attention deficit in bipolar disorder. Br J Psychiatry 2002;180: 313–319. CrossRefGoogle ScholarPubMed
Thompson, JM, Gallagher, P, Hughes, JHet al. Neurocognitive impairment in euthymic patients with bipolar affective disorder. Br J Psychiatry 2005;186:32–40. CrossRefGoogle ScholarPubMed
Martínez-Arán, A, Torrent, C, Tabares-Seisdedos, Ret al. Neurocognitive impairment in bipolar patients with and without history of psychosis. J Clin Psychiatry 2008;69:233–239. CrossRefGoogle ScholarPubMed
McGuffin, P, Rijsdijk, F, Andrew, M, Sham, P, Katz, R, Cardno, A.The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Arch Gen Psychiatry 2003;60:497–502. CrossRefGoogle ScholarPubMed
Kieseppä, T, Partonen, J, Haukka, J, Kaprio, J, Lonnqvis, J.High concordance of bipolar disorder in a nationwide sample of twins. Am J Psychiatry 2004;161:1814–1821. CrossRefGoogle Scholar
Gottesman, II, Gould, TD.The endophenotype concept in psychiatry: etymology and strategic intentions. Am J Psychiatry 2003;160:636–645. CrossRefGoogle ScholarPubMed
Bora, E, Yucel, M, Pantelis, C.Cognitive endophenotypes of bipolar disorder: a meta-analysis of neuropsychological deficits in euthymic patients and their first-degree relatives. J Affect Disord 2008;113:1–20. CrossRefGoogle ScholarPubMed
Andrés, P.Frontal cortex as the central executive of working memory: time to revise our view (Review). Cortex 2003;39:871–895. CrossRefGoogle Scholar
Aron, AR.The neural basis of inhibition in cognitive control (Review). Neuroscientist 2007;13:214–228. CrossRefGoogle Scholar
Logan, GD, Cowan, WB, Davis, KA.On the ability to inhibit simple and choice reaction time responses: a model and a method. J Exp Psychol Hum Percept Perform 1984;10:276–291. CrossRefGoogle Scholar
Miyake, A, Friedman, NP, Emerson, MJ, Witzki, AH, Howerter, A, Wager, TD.The unity and diversity of executive functions and their contributions to complex ‘Frontal Lobe’ tasks: a latent variable analysis. Cognit Psychol 2000;41:49–100. CrossRefGoogle ScholarPubMed
Stuphorn, V, Schall, JD.Executive control of countermanding saccades by the supplementary eye field. Nat Neurosci 2006;9:925–931. CrossRefGoogle ScholarPubMed
Swann, AC, Steinberg, JL, Lijffijt, M, Moeller, FG.Impulsivity: differential relationship to depression and mania in bipolar disorder. J Affect Disord 2008;106: 241–248. CrossRefGoogle ScholarPubMed
Strakowski, SM, Delbello, MP, Adler, CM.The functional neuroanatomy of bipolar disorder: a review of neuroimaging findings (Review). Mol Psychiatry 2005;10: 105–116. CrossRefGoogle ScholarPubMed
Green, MJ, Cahill, CM, Malhi, GS.The cognitive and neurophysiological basis of emotion dysregulation in bipolar disorder. J Affect Disord 2007;103:29–42. CrossRefGoogle ScholarPubMed
Phillips, ML.The neural basis of mood dysregulation in bipolar disorder. Cogn Neuropsychiatry 2006;11:233–249. CrossRefGoogle ScholarPubMed
Gur, RC, Erwin, RJ, Gur, RE, Zwil, AS, Heimberg, C, Kraemer, HC.Facial emotion discrimination. Psychiatry Res 1992;42:241–251. CrossRefGoogle ScholarPubMed
McClure, EB, Pope, K, Hoberman, AJ, Pine, DS, Leibenluft, E.Facial expression recognition in adolescents with mood and anxiety disorder. Am J Psychiatry 2003;160: 1172–1174. CrossRefGoogle Scholar
Murphy, FC, Sahakian, JS, Rubinsztein, JS, Michael, A, Rogers, RD, Robbins, TW.Emotional bias and inhibitory control processes in mania and depression. Psychol Med 1999;29:1307–1321. CrossRefGoogle ScholarPubMed
Krüger, S, Seminowicz, D, Goldapple, K, Kennedy, SH, Mayberg, HS.State and trait influences on mood regulation in bipolar disorder: blood flow differences with an acute mood challenge. Biol Psychiatry 2003;54:1274–1283. CrossRefGoogle ScholarPubMed
Krüger, S, Alda, M, Young, LT, Goldapple, K, Parikh, S, Mayberg, HS.Risk and resilience markers in bipolar disorder: brain responses to emotional challenge in bipolar patients and their healthy siblings. Am J Psychiatry 2006;163:257–264. CrossRefGoogle ScholarPubMed
Phillips, ML, Ladouceur, CD, Drevets, WC.Neural systems underlying voluntary and automatic emotion regulation: toward a neural model of bipolar disorder. Mol Psychiatry 2008;829:833–857. CrossRefGoogle Scholar
Gauggel, S, Rieger, M, Feghiff, TA.Inhibition of ongoing responses in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry 2004;75:539–544. CrossRefGoogle ScholarPubMed
Boecker, M, Buecheler, MM, Schroeter, ML, Gauggel, S.Prefrontal brain activation during stop signal response inhibition: an event-related functional near-infrared spectroscopy study. Behav Brain Res 2007;176: 259–266. CrossRefGoogle Scholar
Konrad, K, Gauggel, S, Burmester, K.Lack of inhibition: a motivational deficit in children with attention deficit/hyperactivity disorder and children with traumatic brain injury. Child Neuropsychol 2000;4:286–296. CrossRefGoogle Scholar
Verbruggen, F, Logan, GD.Response inhibition in the stop-signal paradigm. Trends Cogn Sci 2008;12:418–424. CrossRefGoogle ScholarPubMed
Verbruggen, F, Logan, GD.Models of response inhibition in the stop-signal and stop-change paradigms. Neurosci Biobehav Rev 2009;33:647–661. CrossRefGoogle ScholarPubMed
Strauss, DH, Spitzer, RL, Muskin, PR.Maladaptive denial of physical illness: a proposal for DSM-IV. Am J Psychiatry 1990;147:1168–1172. Google ScholarPubMed
Behr, M, Becker, M.Skalen zum Erleben von Emotionen—SEE. Göttingen: Hogrefe, 2004. Google Scholar
Hampel, R, Selg, H.Das Freiburger Persönlichkeitsinventar (FPI-R), 7th edn. Göttingen: Hogrefe, 2001. Google Scholar
Pratto, F, John, OP.Automatic vigilance: the attention-grabbing power of negative social information. J Pers Soc Psychol 1991;61:380–391. CrossRefGoogle ScholarPubMed
Liotti, M, Mayberg, HS, Brannan, SK, McGinnis, S, Jerabek, P, Fox, PT.Differential limbic—cortical correlates of sadness and anxiety in healthy subjects: implications for affective disorders. Biol Psychiatry 2000;48:30–42. CrossRefGoogle ScholarPubMed
Liotti, M, Mayberg, HS, McGinnis, S, Brannan, SL, Jerabek, P.Unmasking disease-specific cerebral blood flow abnormalities: mood challenge in patients with remitted unipolar depression. Am J Psychiatry 2002;159: 1830–1840. CrossRefGoogle ScholarPubMed
Mayberg, HS, Liotti, M, Brannan, SKet al. Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness. Am J Psychiatry 1999;156:675–682. CrossRefGoogle ScholarPubMed
Jacobson, E.Entspannung und Therapie. Stuttgart: Klett-Cotta Verlag, 2006. Google Scholar
Henry, C, Van Den Bulke, D, Bellivier, Fet al. Affective lability and affect intensity as core dimensions of bipolar disorders during euthymic period. Psychiatry Res 2008;159:1–6. CrossRefGoogle ScholarPubMed
M’Bailara, K, Demotes-Mainard, J, Swendsen, J, Mythieu, F, Leboyer, M, Henry, C.Emotional hyper-reactivity in normothymic bipolar patients. Bipolar Disorder 2009;11:63–69. CrossRefGoogle ScholarPubMed
Buck, R.Human motivation and emotion, 2nd edn. New York: Wiley, 1988. Google Scholar
Yates, JF.Judgement and decision making. Englewood Cliffs, NJ: Prentice-Hall, 1990. Google Scholar
Yerkes, RM, Dodson, JD.The relation of strength of stimulus to rapidity of habit-formation. J Comp Neurol Psychol 1908;18:459–482. CrossRefGoogle Scholar
Eysenck, M, Calvo, M.Anxiety and performance: the processing efficiency theory. Cogn Emot 1992;6:409–434. CrossRefGoogle Scholar
Kaufmann, BE.Emotional arousal as a source of bounded rationality. J Econ Behav Organ 1999;38:135–144. CrossRefGoogle Scholar
Wessa, M, Houenou, J, Paillère-Martinot, MLet al. Fronto-striatal overactivation in euthymic bipolar patients during an emotional go/nogo task. Am J Psychiatry 2007;164:638–646. CrossRefGoogle ScholarPubMed
Dillon, DG, Pizzagalli, DA.Inhibition of action, thought, and emotion: a selective neurobiological review. Appl Prev Psychol 2007;12:99–114. CrossRefGoogle ScholarPubMed
Liddle, EB, Scerif, G, Hollis, CPet al. Looking before you leap: a theory of motivated control of action. Cognition 2009;112:141–158. CrossRefGoogle ScholarPubMed
Verbruggen, F, Logan, GD.Proactive adjustments of response strategies in the stop-signal paradigm. J Exp Psychol-Hum Percept Perform 2009;35:835–854. CrossRefGoogle ScholarPubMed
Frangou, S, Haldane, M, Roddy, M, Kumari, V.Evidence for deficits in tasks of ventral, but not dorsal, prefrontal executive function as an endophenotypic marker for bipolar disorder. Biol Psychiatry 2005;58:838–839. CrossRefGoogle Scholar
Frangou, S, Donaldson, S, Hadjulis, M, Landau, S, Goldstein, LH.The Maudsley Bipolar Disorder Project: executive dysfunction in bipolar disorder I and its clinical correlates. Biol Psychiatry 2005;58:859–864. CrossRefGoogle ScholarPubMed
Hessen, E, Lossius, MI, Reinvang, I, Gjerstad, L.Influence of major antiepileptic drugs on attention, reaction time, and speed of information processing: results from a randomized, double-blind, placebo-controlled withdrawal study of seizure-free epilepsy patients receiving monotherapy. Epilepsia 2006;47:2038–2045. CrossRefGoogle ScholarPubMed
Holmes, MK, Erickson, K, Luckenbaugh, DAet al. A comparison of cognitive functioning in medicated and unmedicated subjects with bipolar depression. Bipolar Disord 2008;10:806–815. CrossRefGoogle ScholarPubMed
Hare, TA, Tottenham, N, Davidson, MC, Glover, GH, Casey, BJ.Contributions of amygdala and striatal activity in emotion regulation. Biol Psychiatry 2005;57:624–632. CrossRefGoogle ScholarPubMed
Verbruggen, F.Do emotional stimuli interfere with response inhibition? Evidence from the stop signal paradigm. Cogn Emot 2007;21:391–403. CrossRefGoogle Scholar